Report links brain health to sleep

The following column was originally published in The Woonsocket Call on Jan. 16, 2017:

Seven to eight hours of sleep per day may be key to maintaining your brain health as you age, says a newly released consensus report issued the Global Council on Brain Health (GCBH). The report’s recommendations, hammered out by scientists, health professionals, scholars and policy experts working on brain health issues at meeting convened by AARP with support of Age UK, in Toronto, Canada in late July 2016 Toronto, translates the scientific research evidence compiled on sleep and brain health into actionable recommendations for the public.

An AARP consumer survey released this month [in conjunction with GCBH’s report] found that 99 percent of age 50plus respondents believe that their sleep is crucial to brain health, but over four in 10 (43 percent) say they don’t get enough sleep during the night. More than half (about 54 percent) say they tend to wake up too early in the morning and just can’t get back to sleep.

As to sleep habits, the adult respondents say that the most frequently cited activity that they engage in within an hour of bedtime are watching television and browsing the web. One-third keep a phone or electronic device by their bed. Nearly 88 percent of the adults think a cool bedroom temperature is effective in helping people sleep. Yet only two in five (41 percent) keep their room between 60 and 67 degrees. Finally, the most common reason people walk up during the night is to use the bathroom.

“Although sleep problems are a huge issue with older adults, it’s unfortunate the importance of sleep is often not taken seriously by health care professionals,” said Sarah Lock, AARP Senior Vice President for Policy, and GCBH Executive Director. “It’s normal for sleep to change as we age, but poor quality sleep is not normal. Our experts share [in GCBH’s report] the steps people can take to help maintain their brain health through better sleep habits,” said Lock, in a statement released with the report.

Sleep vital to brain health

The new GCBH recommendations cover a wide range of sleep-related issues, including common factors that can disrupt sleep, symptoms of potential sleep disorders, and prescription medications and over-the-counter (OTC) sleep aids. The consensus report is jam-packed with tips from experts, from detailing ways to help a person fall asleep or even stay asleep, when to seek professional help for a possible sleep disorder, and the pros and cons of taking a quick nap.

Based on the scientific evidence, the GCBH report says that sleep is vital to brain health, including cognitive function, and sleeping on average 7-8 hours each day is related to better brain and physical health in older people.

The 16-page GCBH consensus report notes that the sleep-wake cycle is influenced by many different factors. A regular sleep-wake schedule is tied to better sleep and better brain health. Regular exposure to light and physical activity supports good sleep, says the report.

According to the GCBH report, people, at any age, can change their behavior to improve their sleep. Persistent, excessive daytime sleepiness is not a normal part of aging. Sleep disorders become more common with age, but can often be successfully treated. People with chronic inadequate sleep are at higher risk for and experience more severe health problems, including dementia, depression, heart disease, obesity and cancer.

“A 2015 consensus statement of the American Academy of Sleep Medicine and the Sleep Research Society mirrors the recently released GCBH report recommending that a person sleep at least 7 hours per night, notes Dr. Katherine M. Sharkey, MD, PhD, FAASM, Associate Professor of Medicine and Psychiatry and Human Behavior who also serves as Assistant Dean for Women in Medicine and Science. “Seven to eight hours seems to be a ‘sweet spot’ for sleep duration,” she says, noting that several studies indicate that sleeping too little or too much can increase risk of mortality.

More sleep not always better

Sharkey says that individuals with insomnia sometimes use a strategy of spending more time in bed, with the idea that if they give themselves more opportunity to sleep, they will get more sleep and feel better, but this can actually make sleep worse. “One of the most commonly used behavioral treatments for insomnia is sleep restriction, where patients work with their sleep clinician to decrease their time in bed to a time very close to the actual amount of sleep they are getting,” she says, noting that this deepens their sleep.

Sleep apnea, a medical disorder where the throat closes off during sleep, resulting in decreased oxygen levels, can reduce the quality of sleep and is often associated with stroke and other cardiovascular diseases, says Sharkey. While sleep apnea is often associated with men (24 percent), it also affects nine percent of woman and this gender gap narrows in older age, she notes.

Many older adults who were diagnosed with sleep apnea many years ago often times did not pursue medical treatment because the older CPAP devices were bulky and uncomfortable, says Sharkey, who acknowledges that this technology is much better today.

“We know how many questions adults have about how much sleep is enough, and the role that sleep plays in brain health and cognitive function,” said Marilyn Albert, Ph.D., GCBH Chair, Professor of Neurology and Director of the Division of Cognitive Neuroscience at Johns Hopkins University in Baltimore, Maryland. “This [GCBH] report answers a lot of these questions and we hope it will be a valuable source of information for people,” she says.

Simple tips to better sleep

Getting a goodnights sleep may be as easy as following these tips detailed in the 16-page GCBH report.

Consider getting up at the same time every day, seven days a week. Restrict fluids and food three hours before going to bed to help avoid disrupting your sleep to use the bathroom. Avoid using OTC medications for sleep because they can have negative side-effects, including disrupted sleep quality and impaired cognitive functioning.

The GCBH report notes that dietary supplements such as melatonin may have benefits for some people, but scientific evidence on their effectiveness is inconclusive. Be particularly cautious of melatonin use with dementia patients.

Naps are not always a cure to enhancing your sleep. Avoid long naps; if you must nap, limit to 30 minutes in the early afternoon.

“There has been such a steady stream of revealing brain-health reports that it would seem people would change their habits accordingly,” said AARP Rhode Island State Director Kathleen Connell. “Taking active steps is what’s important – and the earlier the better,” she added.

“The personal benefits are obvious, but we should be aware of the cost savings that better brain health can produce. If people in their 50s get on board, the impact on healthcare costs and a reduced burden of caregiving 20 years down the road could be significant,” Connell added. “At the very least, those savings could help cover other rising costs. We owe it to ourselves and to each other to assess and improve aspects of diet and exercise. And we should not overlook the importance of sleep.”

The full GCBH recommendations can be found here: http://www.globalcouncilonbrainhealth.org. The 2016 AARP Sleep and Brain Health Survey can be found here: http://www.aarp.org/ sleepandbrainhealth.